Surgical instrument

ABSTRACT

An embodiment of the present invention provides a surgical instrument including: an end tool including a first jaw and a second jaw configured to rotate independently; an operator including a pitch operator controlling a pitch motion of the end tool, a yaw operator controlling a yaw motion of the end tool, and an actuation operator controlling an actuation motion of the end tool; an operating force transmitter including a first jaw wire connected with the first jaw to transmit an operation of the operator to the first jaw, a second jaw wire connected with the second jaw to transmit an operation of the operator to the second jaw, and one or more differential members transmitting a rotation of the yaw operator or the actuation operator to the first jaw or the second jaw via the first jaw wire or the second jaw wire; and a connector configured to extend in a first direction (X axis) and having one end portion coupled to the end tool and the other end portion coupled to the operator to connect the operator and the end tool, wherein the pitch operator is configured to rotate around a second direction (Y axis) perpendicular to the first direction; and at least a portion of the operator is configured to be more adjacent to the end tool than a rotating axis of the operator in at least any one operation state of the operator.

TECHNICAL FIELD

The present invention relates to surgical instruments, and moreparticularly, to surgical instruments that may be manually operated toperform laparoscopic operations or various surgical operations.

BACKGROUND ART

A surgical operation is an operation for curing a disease by cutting,incising, and processing skin, membranes, or other tissues by usingmedical instruments. However, open surgery, which cuts and opens theskin of a surgical region and cures, shapes, or removes an organtherein, may cause bleeding, side effects, pain, scars, or the like.Therefore, a surgical operation, which is performed by forming a holethrough the skin and inserting a medical instrument, for example, alaparoscope, a surgical instrument, or a surgical microscope thereinto,or a robotic surgical operation have recently become popularalternatives.

The surgical instrument is an instrument for performing, by a surgeon,an operation on a surgical region by operating an end tool, which isinstalled at one end of a shaft inserted into a hole formed through theskin, by using an operator or by using a robotic arm. The end toolprovided in the surgical instrument performs a rotating operation, agripping operation, a cutting operation, or the like through apredetermined structure.

However, since a conventional surgical instrument uses an unbendable endtool, it is not suitable for accessing a surgical region and performingvarious surgical operations. In order to solve this problem, a surgicalinstrument having a bendable end tool has been developed. However, anoperation of an operator for bending the end tool to perform a surgicaloperation is not intuitively identical to an actual bending operation ofthe end tool for performing the surgical operation. Therefore, forsurgical operators, it is difficult to perform an intuitive operation,and it takes a long time to learn how to use the surgical instrument.

Information disclosed in this Background section was already known tothe inventors before achieving the present invention or is technicalinformation acquired in the process of achieving the present invention.Therefore, it may contain information that does not form the prior artthat is already known to the public in this country.

DETAILED DESCRIPTION OF THE INVENTION Technical Problem

The present invention provides a surgical instrument that is configuredto intuitively match an actual operation of bending an end tool orperforming a surgical operation with a corresponding operation of anoperator. More particularly, to this end, the present invention providesan end tool having various degrees of freedom, an operator configured tointuitively control an operation of the end tool, and an operating forcetransmitter configured to transmit an operating force of the operator sothat the end tool may operate in accordance with an operation of theoperator.

Technical Solution

According to an embodiment of the present invention, a surgicalinstrument includes: an end tool including a first jaw and a second jawconfigured to rotate independently; an operator including a pitchoperator controlling a pitch motion of the end tool, a yaw operatorcontrolling a yaw motion of the end tool, and an actuation operatorcontrolling an actuation motion of the end tool; an operating forcetransmitter including a first jaw wire connected with the first jaw totransmit an operation of the operator to the first jaw, a second jawwire connected with the second jaw to transmit an operation of theoperator to the second jaw, and one or more differential memberstransmitting a rotation of the yaw operator or the actuation operator tothe first jaw or the second jaw via the first jaw wire or the second jawwire; and a connector configured to extend in a first direction (X axis)and having one end portion coupled to the end tool and the other endportion coupled to the operator to connect the operator and the endtool, wherein the pitch operator is configured to rotate around a seconddirection (Y axis) perpendicular to the first direction; and at least aportion of the operator is configured to be more adjacent to the endtool than a rotating axis of the operator in at least any one operationstate of the operator.

According to another embodiment of the present invention, an end toolincludes: a first jaw and a second jaw configured to rotateindependently of each other; a J11 pulley coupled with the first jaw andconfigured to rotate around a first axis formed at an end tool hub; aJ16 pulley formed at one side of the J11 pulley and configured to rotatearound a second axis formed at one side of the first axis; a J12 pulleyand a J14 pulley formed at one side of the J16 pulley, and configured torotate around a third axis formed at a predetermined angle with thefirst axis, and formed at one side of the end tool hub; a J21 pulleycoupled with the second jaw and configured to rotate around an axis thatis substantially identical to or parallel to the first axis; a J26pulley formed at one side of the J21 pulley and configured to rotatearound an axis that is substantially identical to or parallel to thesecond axis; and a J22 pulley and a J24 pulley formed at one side of theJ26 pulley and configured to rotate around an axis that is substantiallyidentical to or parallel to the third axis, wherein a first jaw wire isconfigured to at least partially contact the J12 pulley, the J11 pulley,the J16 pulley, and the J14 pulley; and a second jaw wire is configuredto at least partially contact the J22 pulley, the J21 pulley, the J26pulley, and the J24 pulley.

These and/or other aspects will become apparent and more readilyappreciated from the following description of the invention, taken inconjunction with the accompanying drawings.

Advantageous Effects of the Invention

According to the present invention, since an operation direction of theoperator by a surgical operator and an operation direction of the endtool are intuitively identical to each other, the convenience of thesurgical operator may be improved, and the accuracy, reliability, andthe quickness of a surgical operation may be improved.

DESCRIPTION OF THE DRAWINGS

FIG. 1A is a schematic diagram illustrating a pitch operation of aconventional surgical instrument, and FIG. 1B is a schematic diagramillustrating a yaw operation thereof.

FIG. 1C is a schematic diagram illustrating a pitch operation of anotherconventional surgical instrument, and FIG. 1D is a schematic diagramillustrating a yaw operation thereof.

FIG. 1E is a schematic diagram illustrating a pitch operation of asurgical instrument according to the present invention, and FIG. 1F is aschematic diagram illustrating a yaw operation thereof.

FIG. 2 is a perspective view of a surgical instrument according to afirst embodiment of the present invention.

FIG. 3 is an internal perspective view of the surgical instrument ofFIG. 2.

FIG. 4 is a side view of the surgical instrument of FIG. 3.

FIG. 5 is a perspective view illustrating an upper portion of anoperator of the surgical instrument of FIG. 3.

FIG. 6 is a perspective view illustrating a lower portion of theoperator of the surgical instrument of FIG. 3.

FIGS. 7 and 8 are perspective views illustrating an end tool of thesurgical instrument of FIG. 3.

FIG. 9A is a plan view illustrating an end tool of the surgicalinstrument of FIG. 3.

FIG. 9B is a plan view illustrating an end tool of a conventionalsurgical instrument.

FIG. 10 is a schematic view illustrating a pitch operation of thesurgical instrument of FIG. 3.

FIG. 11 is a perspective view illustrating a pitch operation of thesurgical instrument of FIG. 3.

FIGS. 12 and 13 are views illustrating a yaw operation of the surgicalinstrument of FIG. 3.

FIGS. 14 and 15 are views illustrating an actuation operation of thesurgical instrument of FIG. 3.

FIG. 16 is a perspective view of a surgical instrument according to asecond embodiment of the present invention.

FIG. 17 is a plan view of the surgical instrument of FIG. 16.

FIG. 18 is a perspective view illustrating an operator of the surgicalinstrument of FIG. 16.

FIG. 19 is a view illustrating a yaw operation of the surgicalinstrument of FIG. 16.

FIGS. 20 and 21 are views illustrating an actuation operation of thesurgical instrument of FIG. 16.

BEST MODE

The present invention may include various embodiments and modifications,and particular embodiments thereof are illustrated in the drawings andwill be described herein in detail. However, it will be understood thatthe present invention is not limited to the embodiments and includes allmodifications, equivalents and substitutions falling within the spiritand scope of the present invention. In the following description,detailed descriptions of well-known functions or configurations will beomitted since they would unnecessarily obscure the subject matters ofthe present invention.

Although terms such as “first” and “second” may be used herein todescribe various elements or components, these elements or componentsshould not be limited by these terms. These terms are only used todistinguish one element or component from another element or component.

The terminology used herein is for the purpose of describing particularembodiments only and is not intended to limit the present invention. Asused herein, the singular forms “a”, “an”, and “the” are intended toinclude the plural forms as well, unless the context clearly indicatesotherwise. It will be understood that terms such as “comprise”,“include”, and “have”, when used herein, specify the presence of statedfeatures, integers, steps, operations, elements, components, orcombinations thereof, but do not preclude the presence or addition ofone or more other features, integers, steps, operations, elements,components, or combinations thereof.

Hereinafter, embodiments of the present invention will be described indetail with reference to the accompanying drawings. In the followingdescription, like reference numerals denote like elements, and redundantdescriptions thereof will be omitted.

Also, it will be understood that various embodiments of the presentinvention may be interpreted or implemented in combination, andtechnical features of each embodiment may be interpreted or implementedin combination with technical features of other embodiments.

<First Embodiment of Surgical Instrument>

A surgical instrument according to the present invention ischaracterized in that, for at least any one of the pitch, yaw, andactuation operations, when an operator is rotated in any one direction,an end tool rotates in a direction that is intuitively identical to anoperation direction of the operator.

FIG. 1A is a schematic diagram illustrating a pitch operation of aconventional surgical instrument, and FIG. 1B is a schematic diagramillustrating a yaw operation thereof.

Referring to FIG. 1A, in order to perform a pitch operation of aconventional surgical instrument, in a state where an end tool 120 a isformed in front of an end tool rotation center 121 a and an operator 110a is formed in back of an operator rotation center 111 a, when theoperator 110 a is rotated in a clockwise direction, the end tool 120 aalso rotates in the clockwise direction, and when the operator 110 a isrotated in a counterclockwise direction, the end tool 120 a also rotatesin the counterclockwise direction. Referring to FIG. 1B, in order toperform a yaw operation of a conventional surgical instrument, in astate where an end tool 120 a is formed in front of an end tool rotationcenter 121 a and an operator 110 a is formed in back of an operatorrotation center 111 a, when the operator 110 a is rotated in a clockwisedirection, the end tool 120 a also rotates in the clockwise direction,and when the operator 110 a is rotated in a counterclockwise direction,the end tool 120 a also rotates in the counterclockwise direction. Inthis case, from the viewpoint of a horizontal direction of a user, whenthe user moves the operator 110 a to the left, the end tool 120 a movesto the right, and when the user moves the operator 110 a to the right,the end tool 120 a moves to the left. Consequently, since the operationdirection of the user and the operation direction of the end tool areopposite to each other, the user may make an error and the operation ofthe user may not be easy.

FIG. 1C is a schematic diagram illustrating a pitch operation of anotherconventional surgical instrument, and FIG. 1D is a schematic diagramillustrating a yaw operation thereof.

Referring to FIG. 1C, in order for another conventional surgicalinstrument to be mirror-symmetrically formed to perform a pitchoperation, in a state where an end tool 120 b is formed in front of anend tool rotation center 121 b and an operator 110 b is formed in backof an operator rotation center 111 b, when the operator 110 b is rotatedin the clockwise direction, the end tool 120 b rotates in thecounterclockwise direction, and when the operator 110 b is rotated inthe counterclockwise direction, the end tool 120 b rotates in theclockwise direction. In this case, from the viewpoint of the rotationdirection of the operator and the end tool, the rotation direction ofthe operator 110 b by the user and the corresponding rotation directionof the end tool 120 b are opposite to each other. Consequently, the usermay confuse the operation direction, the operation of a joint may not beintuitive, and an error may be caused accordingly. Also, referring toFIG. 1D, in order to perform a yaw operation, in a state where an endtool 120 b is formed in front of an end tool rotation center 121 b andan operator 110 b is formed in back of an operator rotation center 111b, when the operator 110 b is rotated in the clockwise direction, theend tool 120 b rotates in the counterclockwise direction, and when theoperator 110 b is rotated in the counterclockwise direction, the endtool 120 b rotates in the clockwise direction. In this case, from theviewpoint of the rotation direction of the operator and the end tool,the rotation direction of the operator 110 b by the user and thecorresponding rotation direction of the end tool 120 b are opposite toeach other. Consequently, the user may confuse the operation direction,the operation of a joint may not be intuitive, and an error may becaused accordingly.

In order to solve this problem, a surgical instrument according to anembodiment of the present invention illustrated in FIGS. 1E and 1F ischaracterized in that an end tool 120 c is formed in front of an endtool rotation center 121 c and an operator 110 c is also formed in frontof an operator rotation center 111 c, so that the operations of theoperator 110 c and the end tool 120 c are intuitively identical to eachother.

In other words, unlike a conventional example of the configuration inwhich the operator becomes adjacent to the user (i.e., becomes distantfrom the end tool) with respect to its own joint as illustrated in FIGS.1A, 1B, 1C, and 1D, the surgical instrument according to an embodimentof the present invention illustrated in FIGS. 1E and 1F is formed suchthat at least a portion of the operator may become more adjacent to theend tool with respect to its own joint (i.e., than its own joint).

In other words, in the case of the conventional surgical instrumentillustrated in FIGS. 1A, 1B, 1C, and 1D, since the end tool is locatedin front of its own rotation center but the operator is formed in backof its own rotation center and thus the end tool moving the front withthe rear fixed is moved by the operation of the operator moving the rearwith the front fixed, they are not structurally intuitively identical toeach other. Consequently, in the operation of the operator and theoperation of the end tool, from the viewpoint of the horizontaldirection or the viewpoint of the rotation direction, a mismatch mayoccur, the user may be confused, the operation of the operator may bedifficult to perform intuitively rapidly, and an error may be causedaccordingly. On the other hand, in the case of the surgical instrumentaccording to an embodiment of the present invention, since both the endtool and the operator move with respect to the rotation center formed atthe rear, the operations may be structurally intuitively identical toeach other. Consequently, the user may intuitively rapidly control theend tool direction, and the possibility of causing an error may besignificantly reduced. A specific mechanism enabling this function willbe described below.

FIG. 2 is a perspective view of a surgical instrument according to afirst embodiment of the present invention, FIG. 3 is an internalperspective view of the surgical instrument of FIG. 2, and FIG. 4 is aside view of the surgical instrument of FIG. 3.

Referring to FIGS. 2, 3, and 4, a surgical instrument 100 according to afirst embodiment of the present invention includes an operator 110, anend tool 120, an operating force transmitter 130, and a connector 140.Herein, the connector 140 may be formed to have the shape of a hollowshaft, so that one or more wires (which will be described later) may beaccommodated therein. The operator 110 may be coupled to one end portionof the connector 140, and the end tool 120 may be coupled to the otherend portion of the connector 140, so that the connector 140 may connectthe operator 110 and the end tool 120.

In detail, the operator 110 is formed at one end portion of theconnector 140, and is provided as an interface having, for example, atweezer shape, a stick shape, or a lever shape, which may be directlyoperated by a surgical operator. When a surgical operator operates theoperator 110, the end tool 120, which is connected to the interface andis inserted into the body of a surgical patient, performs an operation,thereby performing a surgical operation. Although FIG. 2 illustratesthat the operator 110 is formed to have the shape of a handle that maybe rotated with a finger inserted thereinto, the inventive concept isnot limited thereto, and the operator 110 may have various shapes thatmay be connected with the end tool 120 to operate the end tool 120.

The end tool 120 is formed at the other end portion of the connector 140and is inserted into a surgical region to perform a necessary surgicaloperation. As an example of the end tool 120, a pair of jaws, namely,first and second jaws 121 and 122, may be used to perform a gripoperation as illustrated in FIG. 2. However, the inventive concept isnot limited thereto, and various surgical devices may be used as the endtool 120. For example, a one-armed cautery may be used as the end tool120. The end tool 120 is connected with the operator 110 by theoperating force transmitter 130 to receive an operating force of theoperator 110 through the operating force transmitter 130, therebyperforming a necessary surgical operation such as a grip, cutting, orsuturing.

Herein, the end tool 120 of the surgical instrument 100 according to thefirst embodiment of the present invention is formed to rotate in two ormore directions. For example, the end tool 120 may be formed to performa pitch motion around a Y axis of FIG. 2 and also perform a yaw motionand an actuation motion around a Z axis of FIG. 2. This will bedescribed later in detail.

The operating force transmitter 130 connects the operator 110 and theend tool 120 to transmit an operating force of the operator 110 to theend tool 120, and may include a plurality of wires, pulleys, links,nodes, and gears.

Hereinafter, the operator 110, the end tool 120, and the operating forcetransmitter 130 of the surgical instrument 100 of FIG. 2 will bedescribed in more detail.

(Operator)

FIG. 5 is a perspective view illustrating an upper portion of theoperator of the surgical instrument of FIG. 3, and FIG. 6 is aperspective view illustrating a lower portion of the operator of thesurgical instrument of FIG. 3.

Referring to FIGS. 2 to 6, the operator 110 of the surgical instrument100 according to the first embodiment of the present invention includesa pitch operator 111 controlling a pitch motion of the end tool 120, ayaw operator 112 controlling a yaw motion of the end tool 120, and anactuation operator 113 controlling an actuation motion of the end tool120.

First, as an example of the use state of the surgical instrument 100 ofFIG. 2, the user may grip a pitch operating handle (or bar) 1112 of thepitch operator 111 with the palm and rotate the pitch operating handle1112 to perform a pitch motion, may insert the index finger into the yawoperator 112 and rotate the yaw operator 112 to perform a yaw motion,and may insert the big finger into the actuation operator 113 and rotatethe actuation operator 113 to perform an actuation motion.

A pitch operation, a yaw operation, and an actuation operation used inthe present invention are summarized as follows:

First, the pitch operation refers to an operation of rotating the endtool 120 in the vertical direction with respect to the connector 140,that is, an operation of rotating around the Y axis of FIG. 2. In otherwords, the pitch operation refers to a vertical rotation of the end tool120, which is formed to extend in the extension direction (the X-axisdirection of FIG. 2) of the connector 140, around the Y axis withrespect to the connector 140. The yaw operation refers to an operationof rotating the end tool 120 in the horizontal direction with respect tothe connector 140, that is, an operation of rotating around the Z axisof FIG. 2. In other words, the yaw operation refers to a horizontalrotation of the end tool 120, which is formed to extend in the extensiondirection (the X-axis direction of FIG. 2) of the connector 140, aroundthe Z axis with respect to the connector 140. The actuation operationrefers a folding or unfolding operation of the jaws 121 and 122 when thejaws 121 and 122 rotate in opposite directions while rotating around thesame rotating axis as the yaw operation. That is, the actuationoperation refers to rotations of the jaws 121 and 122, which is formedat the end tool 120, in opposite directions around the Z axis.

Herein, when the operator 110 of the surgical instrument 100 is rotatedin one direction with respect to the connector 140, the end tool 120rotates with respect to the connector 140 in a direction that isintuitively identical to an operation direction of the operator 110. Inother words, when the pitch operator 111 of the operator 110 rotates inone direction, the end tool 120 rotates in a direction intuitivelyidentical to the one direction to perform a pitch operation, and whenthe yaw operator 112 of the operator 110 rotates in one direction, theend tool 120 rotates in a direction intuitively identical to the onedirection to perform a yaw operation. Herein, it may be said that theintuitively identical direction refers to a case where a movementdirection of the index finger of the user gripping the operator 110 issubstantially identical to a movement direction of the end portion ofthe end tool 120. In addition, the identical direction may not be anexactly identical direction on a three-dimensional coordinate system.For example, the identical direction may refer to a case where when theindex finger of the user moves to the left, the end portion of the endtool 120 also moves to the left, and when the index finger of the usermoves to the right, the end portion of the end tool 120 also moves tothe right, in order to maintain intuition.

To this end, in the surgical instrument 100, the operator 110 and theend tool 120 are formed in the same direction with respect to a planeperpendicular to the extension axis (X axis) of the connector 140. Thatis, in view of a YZ plane of FIG. 2, the operator 110 is formed toextend in a +X-axis direction, and the end tool 120 is also formed toextend in the +X-axis direction. In other words, it may be said that aformation direction of the end tool 120 at one end portion of theconnector 140 may be identical to a formation direction of the operator110 at the other end portion of the connector 140 in view of the YZplane. In other words, it may be said that the operator 110 is formed toextend away from the body of the user gripping the operator 110, thatis, the operator 110 is formed to extend toward the end tool 120.

In detail, in the case of a related art surgical instrument, anoperation direction of an operator by a user is different from and isnot intuitively identical to an actual operation direction of an endtool. Therefore, a surgical operator has difficulty in performing anintuitive operation, and it takes a long time to skillfully move the endtool in a desired direction. Also, in some cases, a faulty operation mayoccur, thus damaging a surgical patient.

In order to solve such problems, the surgical instrument 100 accordingto the first embodiment of the present invention is configured such thatan operation direction of the operator 110 is intuitively identical toan operation direction of the end tool 120. To this end, the operator110 and the end tool 120 are formed on the same side in view of the YZplane including a pitch operating axis 1111. This will be describedbelow in more detail.

The pitch operator 111 includes a pitch operating axis 1111 and a pitchoperating handle 1112. Herein, the pitch operating axis 1111 may beformed in the direction parallel to the Y axis, and the pitch operatinghandle 1112 may be connected with the pitch operating axis 1111 torotate along with the pitch operating axis 1111. For example, when theuser grips and rotates the pitch operating handle 1112, the pitchoperating handle 1112 rotates around the pitch operating axis 1111.Then, the resulting rotating force is transmitted to the end tool 120through the operating force transmitter 130, an operator control member115, and an end tool control member 123, so that the end tool 120rotates in the same direction as the rotation direction of the pitchoperator 111. That is, when the pitch operator 111 rotates in theclockwise direction around the pitch operating axis 1111, the end tool120 also rotates in the clockwise direction around an axis parallel tothe pitch operating axis 1111, and when the pitch operator 111 rotatesin the counterclockwise direction around the pitch operating axis 1111,the end tool 120 also rotates in the counterclockwise direction aroundthe axis parallel to the pitch operating axis 1111.

The yaw operator 112 and the actuation operator 113 are formed on oneend portion of the pitch operating handle 1112 of the pitch operator111. Thus, when the pitch operator 111 rotates around the pitchoperating axis 1111, the yaw operator 112 and the actuation operator 113also rotate along with the pitch operator 111. FIG. 2 illustrates astate in which the pitch operating handle 1112 of the pitch operator 111is perpendicular to the connector 140, while FIG. 11 illustrates a statein which the pitch operating handle 1112 of the pitch operator 111 is atan angle to the connector 140 by rotating around the pitch operatingaxis 1111 by some degree.

Therefore, a coordinate system of the yaw operator 112 and the actuationoperator 113 is not fixed, but relatively changes according to therotation of the pitch operator 111. That is, FIG. 2 illustrates that ayaw operating axis 1121 of the yaw operator 112 is parallel to the Zaxis and an actuation operating axis 1131 of the actuation operator 113is parallel to the Y axis. However, when the pitch operator 111 isrotated, the yaw operating axis 1121 of the yaw operator 112 is notparallel to the Z axis. That is, the coordinate system of the yawoperator 112 and the actuation operator 113 change according to therotation of the pitch operator 111. However, for convenience ofdescription, the coordinate system of the yaw operator 112 and theactuation operator 113 will be described on the assumption that thepitch operating handle 1112 is perpendicular to the connector 140 asillustrated in FIG. 2.

The yaw operator 112 includes a yaw operating axis 1121 and a yawoperating member 1122. Herein, the yaw operating axis 1121 may be formedto be at a predetermined angle to an XY plane where the connector 140 isformed. For example, the yaw operating axis 1121 may be formed in adirection parallel to the Z axis as illustrated in FIG. 3, and when thepitch operator 111 rotates, the coordinate system of the yaw operator112 may relatively change as described above. However, the inventiveconcept is not limited thereto, and the yaw operating axis 1121 may beformed in various directions by ergonomic design according to thestructure of the hand of the user gripping the yaw operator 112.

The yaw operating member 1122 is formed to rotate around the yawoperating axis 1121. For example, when the user holds and rotates theyaw operating member 1122 by the index finger, the yaw operating member1122 rotates around the yaw operating axis 1121. Then, the resultingrotating force is transmitted to the end tool 120 through the operatingforce transmitter 130, so that the jaws 121 and 122 of the end tool 120horizontally rotate in the same direction as the rotation direction ofthe yaw operating member 1122. To this end, a pulley 1121 a may beformed at the yaw operating axis 1121. Also, a yaw wire 130Y may beconnected to the pulley 1121 a, and the rotating force may betransmitted to the end tool 120 through the operating force transmitter130 including the yaw wire 130Y, so that the jaws 121 and 122 of the endtool 120 may perform a yaw operation.

The actuation operator 113 includes an actuation operating axis 1131 andan actuation operating member 1132. Herein, the actuation operating axis1131 may be formed to be at a predetermined angle to the XZ plane wherethe connector 140 is formed. For example, the actuation operating axis1131 may be formed in a direction parallel to the Y axis as illustratedin FIG. 2, and when the pitch operator 111 rotates, the coordinatesystem of the actuation operator 113 may relatively change as describedabove. However, the inventive concept is not limited thereto, and theactuation operating axis 1131 may be formed in various directions byergonomic design according to the structure of the hand of the usergripping the actuation operator 113.

The actuation operating member 1132 is formed to rotate around theactuation operating axis 1131. For example, when the user holds androtates the actuation operating member 1132 by the big finger, theactuation operating member 1132 rotates around the actuation operatingaxis 1131. Then, the resulting rotating force is transmitted to the endtool 120 through the operating force transmitter 130, so that the jaws121 and 122 of the end tool 120 perform an actuation operation. Herein,as described above, the actuation operation refers to an operation offolding or unfolding the jaws 121 and 122 by rotating the jaws 121 and122 in opposite directions. That is, when the actuation operator 113 isrotated in one direction, as the first jaw 121 rotates in thecounterclockwise direction and the second jaw 122 rotates in theclockwise direction, the end tool 120 is folded; and when the actuationoperator 113 is rotated in the opposite direction, as the first jaw 121rotates in the clockwise direction and the second jaw 122 rotates in thecounterclockwise direction, the end tool 120 is unfolded.

A pulley 1131 a may be formed at one end portion of the actuationoperating axis 1131. An actuation wire 130A may be connected to thepulley 1131 a.

Referring to FIG. 3, the pitch operating axis 111 of the pitch operator111 and the end tool 120 are formed on the same or parallel axis (Xaxis) in the surgical instrument 100 according to the first embodimentof the present invention. That is, the pitch operating axis 1111 of thepitch operator 111 is formed at one end portion of the connector 140,and the end tool 120 is formed at the other end portion of the connector140. Although it is illustrated that the connector 140 is formed to havethe shape of a straight line, the inventive concept is not limitedthereto. For example, the connector 140 may be curved with apredetermined curvature, or may be bent one or more times. Also in thiscase, it may be said that the pitch operator 111 and the end tool 120are formed on substantially the same or parallel axis. Although FIG. 3illustrates that the pitch operator 111 and the end tool 120 are formedon the same axis (X axis), the inventive concept is not limited thereto.For example, the pitch operator 111 and the end tool 120 may be formedon different axes.

As described above, in the surgical instrument 100 according to thefirst embodiment of the present invention, the end tool 120 and theoperator 110 are formed to extend in the same direction so that thejoint operations (e.g., pitch operation and yaw operation) of the endtool 120 and the operator 110 are intuitively identical to each other.

In other words, as illustrated in FIGS. 1E and 1F, as the end tool 120 cis formed in front of the end tool rotation center 121 c, the operator110 c is also formed in front of the operator rotation center 111 c.

Also, since the yaw operator 112 is formed at one end portion of thepitch operator 111, when the pitch operator 111 rotates around the pitchoperating axis 1111, the yaw operator 112 also moves around the pitchoperating axis 1111 but the end tool 120 also performs a pitch rotation,so that the intuition of the identity between the direction of the yawoperator 112 and the direction of the end tool 120 is not damaged.

That is, even when the extension direction of the yaw operator 112changes from the +X-axis direction of FIG. 2 by the pitch motion of thepitch operator 111, since the end tool 120 also performs a pitchrotation, the intuition of the identity between the direction of the yawoperator 112 and the direction of the end tool 120 is not damaged.

Thus, although FIG. 2 illustrates the inventive concept that “theoperator is formed to extend toward the end tool” in the state of nojoint rotation, it may be understood that “the operator is formed toextend toward the end tool” even in the state of a joint rotation inview of the above description.

That is, although the shape of the operator being formed to extendtoward the end tool may change according to the operation of anotheroperator, it should be understood in view of the above description, andthe shape of the operator being formed to extend toward the end tool maybe satisfied in at least any one of various operation states of theoperator.

That is, the feature of the operator 110 being formed to extend towardthe end tool 120 may also represent that a portion of the operator 110may become more adjacent to the end tool 120 at least any one moment ofthe operation with respect to its own joint (i.e., than its own joint).

The operator 110 of the surgical instrument 100 according to the firstembodiment of the present invention further includes an operator controlmember 115 engaged with the pitch operating axis 1111 of the pitchoperator 111. Since the operator control member 115 has substantiallythe same configuration as the end tool control member 123 describedlater, the relationship between the operator control member 115 andother components of the operator 110 and the end tool control member 123will be described later.

(Operating Force Transmitter)

Referring to FIGS. 2 to 6, the operating force transmitter 130 of thesurgical instrument 100 according to the first embodiment of the presentinvention includes a yaw wire 130Y, an actuation wire 130A, a pitch wire130P, a first jaw wire 130J1, a second jaw wire 130J2, and an operatingforce transmission assembly 135. Herein, the operating forcetransmission assembly 135 may be accommodated in the pitch operatinghandle 1112.

First, the operating force transmission assembly 135 of the operatingforce transmitter 130 will be described below.

As described above, the yaw operator 112 and the actuation operator 113are formed on one end portion of the pitch operating handle 1112 of thepitch operator 111. Thus, when the pitch operator 111 rotates around thepitch operating axis 1111, the yaw operator 112 and the actuationoperator 113 also rotate along with the pitch operator 111. Also, theyaw operator 112 is connected with the first jaw 121 and the second jaw122 to operate the first jaw 121 and the second jaw 122, and theactuation operator 113 is connected with the first jaw 121 and thesecond jaw 122 to operate the first jaw 121 and the second jaw 122.However, when the yaw operator 112 is rotated, the first jaw 121 and thesecond jaw 122 have to rotate in the same direction; and when theactuation operator 113 is rotated, the first jaw 121 and the second jaw122 have to rotate in opposite directions. In order to implement thisoperation, a separate structure is required.

Thus, two rotation inputs of the yaw operator 112 and the actuationoperator 113 have to be applied to one jaw. Accordingly, a structure forreceiving two or more inputs, outputting a rotation of one jaw, andoperating differently according to the respective inputs is required. Inthis case, two rotation inputs have to be independent of each other.

To this end, the surgical instrument 100 according to the firstembodiment of the present invention includes an operating forcetransmission assembly 135 that receives an operating force from the yawoperator 112 and the actuation operator 113 and transmits the operatingforce to the first jaw 121 and the second jaw 122.

In detail, the operating force transmission assembly 135 includes a yawpulley 135YP, a yaw operating bar 135B, a first gear 135G1, and a fourthgear 135G4 that are connected with the yaw operator 112 through the yawwire 130Y to rotate along with the yaw operator 112. Herein, the yawpulley 135YP, the yaw operating bar 135B, the first gear 135G1, and thefourth gear 135G4 rotate together. Also, it includes a first jawoperating member 135J1 for transmitting an operating force to rotate thefirst jaw 121 according to the rotation of the yaw operator 112 and theactuation operator 113, and a second jaw operating member 135J2 fortransmitting an operating force to rotate the second jaw 122 accordingto the rotation of the yaw operator 112 and the actuation operator 113.Also, it further includes an actuation gear 135AG rotating along withthe actuation operator 113, a second gear 135G2 interposed between thefirst gear 135G1 and the actuation gear 135AG, and a third gear 135G3interposed between the actuation gear 135AG and the fourth gear 135G4.In this case, the first gear 135G1, the second gear 135G2, the thirdgear 135G3, and the fourth gear 135G4 may be sequentially stacked in theZ-axis direction to rotate around a pitch operator center axis 1113. Inthis case, the actuation gear 135AG rotates around an actuation gearcenter axis 135AG1 that is fixedly formed in the direction perpendicularto the Z axis. The actuation gear 135AG is connected with the actuationwire 130A to rotate along with the pulley 1131 a of the actuationoperator 113. This will be described below in more detail.

The first jaw operating member 135J1 includes a first jaw operating gear135J11, a first jaw connecting member 135J12, a first jaw operatingpulley 135J13, and a first jaw operating gear center axis 135J14. Thefirst jaw operating gear 135J11 is interposed in the form of a bevelgear between the third gear 135G3 and the fourth gear 135G4 to revolvearound the pitch operator center axis 1113 or rotate around the firstjaw operating gear center axis 135J14 according to the relative movementof the third gear 135G3 or the fourth gear 135G4. The first jawconnecting member 135J12 may be formed to connect the first jawoperating gear center axis 135J14 and the first jaw operating pulley135J13, so that the first jaw operating gear 135J11, the first jawoperating gear center axis 135J14, the first jaw connecting member135J12, and the first jaw operating pulley 135J13 may rotate togetheraround the pitch operator center axis 1113. The first jaw operatingpulley 135J13 may be connected with the first jaw wire 130J1 to transmitthe rotation of the yaw operator 112 and the actuation operator 113 tothe first jaw 121.

The second jaw operating member 135J2 includes a second jaw operatinggear 135J21, a second jaw connecting member 135J22, a second jawoperating pulley 135J23, and a second jaw operating gear center axis135J24. The second jaw operating gear 135J21 is interposed in the formof a bevel gear between the first gear 135G1 and the second gear 135G2to revolve around the pitch operator center axis 1113 or rotate aroundthe second jaw operating gear center axis 135J24 according to therelative movement of the first gear 135G1 or the second gear 135G2. Thesecond jaw connecting member 135J22 may be formed to connect the secondjaw operating gear center axis 135J24 and the second jaw operatingpulley 135J23, so that the second jaw operating gear 135J21, the secondjaw operating gear center axis 135J24, the second jaw connecting member135J22, and the second jaw operating pulley 135J23 may rotate togetheraround the pitch operator center axis 1113. The second jaw operatingpulley 135J23 may be connected with the second jaw wire 130J2 totransmit the rotation of the yaw operator 112 and the actuation operator113 to the second jaw 122.

The operating force transmission assembly 135 may be described below inmore detail. The first jaw 121 and the second jaw 122 should rotate withrespect to two rotation inputs of the yaw operator 112 and the actuationoperator 113, wherein the first jaw 121 and the second jaw 122 shouldoperate differently with respect to the operation of each of the yawoperator 112 and the actuation operator 113. That is, when the yawoperator 112 is rotated, the first jaw 121 and the second jaw 122 shouldrotate in the same direction; and when the actuation operator 113 isrotated, the first jaw 121 and the second jaw 122 should rotate inopposite directions.

In order to implement this operation, a structure is required todetermine the operation of the first jaw 121 with respect to the tworotation inputs of the yaw operator 112 and the actuation operator 113,and the structure includes a first jaw operating gear 135J11, a fourthgear 135G4, and a third gear 135G3 (hereinafter referred to as firstdifferential member).

Also, a structure for determining the operation of the second jaw 122with respect to the two rotation inputs of the yaw operator 112 and theactuation operator 113 includes a second jaw operating gear 135J21, afirst gear 135G1, and a second gear 135G2 (hereinafter referred to assecond differential member).

Each of the structures (i.e., the first differential member and thesecond differential member) includes two input gears and one outputgear.

In more detail, the first differential member receives the rotation ofthe fourth gear 135G4 and the third gear 135G3 and outputs the rotationof the first jaw operating gear 135J11, and the second differentialmember receives the rotation of the first gear 135G1 and the second gear135G2 and outputs the rotation of the second jaw operating gear 135J21.

In each operating system, the output gear is rotated according to therotation input of two input gears, and when the output gear rotates, theentire of the second jaw operating member 135J2 or the jaw operatingmember (the first jaw operating member 135J1) including the output gearrevolves around the pitch operator center axis 1113 in the samedirection as one rotation direction of the input gear. Thus, eachoperating system may receive two inputs to rotate the output gearwithout affecting another input.

That is, the first differential member may rotate the first jaw 121according to the rotation input of the yaw operator 112 or the actuationoperator 113, and the second differential member may rotate the secondjaw 122 according to the rotation of the yaw operator 112 or theactuation operator 113.

In this case, when the yaw operator 112 rotates, the first jaw 121 andthe second jaw 122 should rotate in the same direction; and when theactuation operator 113 rotates, the first jaw 121 and the second jaw 122should rotate in different directions.

Thus, the rotation operation of the yaw operator 112 is configured torotate one input gear of the second differential member and the firstdifferential member in the same direction, and the rotation operation ofthe actuation operator 113 is configured to rotate the other input gearof the second differential member and the first differential member inopposite directions.

To this end, the rotation operation of the yaw operator 112 isconfigured to connect the yaw operating bar 135B to the first gear 135G1and the fourth gear 135G4 to rotate the first gear 135G1 and the fourthgear 135G4 in the same direction and thus rotate the first jaw operatinggear 135J11 and the second jaw operating gear 135J21 in the samedirection, so that the first jaw 121 and the second jaw 122 rotate inthe same direction to perform a yaw operation.

On the other hand, the rotation operation of the actuation operator 113is configured to rotate the second gear 135G2 and the third gear 135G3in opposite directions by the actuation gear 135AG and thus rotate thefirst jaw operating gear 135J11 and the second jaw operating gear 135J21in opposite directions, so that the first jaw 121 and the second jaw 122rotate in opposite directions to perform an actuation operation.Although the present embodiment illustrates the gear as the operatingsystem for extracting one output from two inputs, the inventive conceptis not limited thereto and various other operating systems may also beused to extract one output from two inputs.

Although it is illustrated that the first gear 135G1, the second gear135G2, the third gear 135G3, and the fourth gear 135G4 are sequentiallystacked and formed along the pitch operator center axis 1113, theinventive concept is not limited thereto and the above gears may also beformed along the pitch operator center axis 1113 and a separatedifferential member center axis.

(End Tool)

FIGS. 7 and 8 are perspective views illustrating the end tool of thesurgical instrument of FIG. 3, and FIG. 9A is a plan view illustratingthe end tool of the surgical instrument of FIG. 3.

Referring to FIGS. 7, 8, and 9A, the end tool 120 according to the firstembodiment of the present invention includes an end tool control member123, and the end tool control member 123 includes a J11 pulley 123J11, aJ12 pulley 123J12, a J13 pulley 123J13, a J14 pulley 123J14, and a J15pulley 123J15 that are related to the rotation motion of the first jaw121, and a J21 pulley 123J21, a J22 pulley 123J22, a J23 pulley 123J23,a J24 pulley 123J24, and a J25 pulley 123J25 that are related to therotation motion of the second jaw 122. Herein, the first jaw 121, theJ11 pulley 123J11, the J12 pulley 123J12, the J14 pulley 123J14, thesecond jaw 122, the J21 pulley 123J21, the J22 pulley 123J22, and theJ24 pulley 123J24 may be formed to rotate around an end tool pitchoperating axis 123PA.

A connector hub 141 may be formed at one end portion of the connector140 coupled with the end tool 120. The J12 pulley 123J12, the J13 pulley123J13, the J14 pulley 123J14, the J15 pulley 123J15, the J22 pulley123J22, the J23 pulley 123J23, the J24 pulley 123J24, and the J25 pulley123J25 may be coupled to the connector hub 141.

Although it is illustrated that pulleys facing each other are formed tobe parallel to each other, the inventive concept is not limited theretoand the pulleys may be formed to have various positions and sizessuitable for the configuration of the end tool.

The J11 pulley 123J11 and the J21 pulley 123J21 are formed to face eachother and rotate independently around a jaw rotating axis 123JA. Herein,the first jaw 121 may be coupled to the J11 pulley 123J11 to rotatealong with the J11 pulley 123J11, and the second jaw 122 may be coupledto the J21 pulley 123J21 to rotate along with the J21 pulley 123J21. Ayaw operation and an actuation operation of the end tool 120 areperformed according to the rotations of the J11 pulley 123J11 and theJ21 pulley 123J21. That is, the yaw operation is performed when the J11pulley 123J11 and the J21 pulley 123J21 rotate in the same direction,and the actuation operation is performed when the J11 pulley 123J11 andthe J21 pulley 123J21 rotate in opposite directions.

A J16 pulley 123J16 and a J26 pulley 123J26 may be additionally providedas additional pulleys on one side of the J11 pulley 123J11 and the J21pulley 123J21, and the additional pulleys may be formed to rotate aroundan additional pulley axis 123S. Although it is illustrated that the J16pulley 123J16 and the J26 pulley 123J26 are formed to rotate around oneadditional pulley axis 123S, each of the additional pulleys may also beformed to rotate around a separate axis. In other words, as theadditional pulley, the J16 pulley 123J16 may be disposed between the J11pulley 123J11 and the J12 pulley 123J12/the J14 pulley 123J14. Also, asthe additional pulley, the J26 pulley 123J26 may be disposed between theJ21 pulley 123J21 and the J22 pulley 123J22/the J24 pulley 123J24. Theadditional pulleys will be described later in more detail.

The elements related to the rotation of the J11 pulley 123J11 will bedescribed below.

On one side of the J11 pulley 123J11, the J12 pulley 123J12 and the J14pulley 123J14 are disposed to face each other. Herein, the J12 pulley123J12 and the J14 pulley 123J14 are formed to rotate independentlyaround the Y-axis direction. Also, on one side of the J12 pulley 123J12and the J14 pulley 123J14, the J13 pulley 123J13 and the J15 pulley123J15 are disposed to face each other. Herein, the J13 pulley 123J13and the J15 pulley 123J15 are formed to rotate independently around theY-axis direction. Although it is illustrated that all of the J12 pulley123J12, the J13 pulley 123J13, the J14 pulley 123J14, and the J15 pulley123J15 are formed to rotate around the Y-axis direction, the presentinvention is not limited thereto, and the rotating axes of therespective pulleys may be formed in various directions according totheir configurations.

The first jaw operating wire 130J1 may be wound to at least partiallycontact the J13 pulley 123J13, the J12 pulley 123J12, the J11 pulley123J11, the J16 pulley 123J16, the J14 pulley 123J14, and the J15 pulley123J15, and the first jaw operating wire 130J1 may move along the abovepulleys while rotating the above pulleys.

Thus, when the first jaw operating wire 130J1 is pulled in the directionof an arrow J1R of FIG. 9A, the first jaw operating wire 130J1 rotatesthe J15 pulley 123J15, the J14 pulley 123J14, the J16 pulley 123J16, theJ11 pulley 123J11, the J12 pulley 123J12, and the J13 pulley 123J13. Inthis case, the J11 pulley 123J11 rotates in the direction of an arrow Rof FIG. 9A to rotate the first jaw 121 together.

On the other hand, when the first jaw operating wire 130J1 is pulled inthe direction of an arrow J1L of FIG. 9A, the first jaw operating wire130J1 rotates the J13 pulley 123J13, the J12 pulley 123J12, the J11pulley 123J11, the J16 pulley 123J16, the J14 pulley 123J14, and the J15pulley 123J15. In this case, the J11 pulley 123J11 rotates in thedirection of an arrow L of FIG. 9A to rotate the first jaw 121 together.

The additional pulleys 123J16 and 123J26 will be described below in moredetail.

The additional pulleys 123J16 and 123J26 may contact the first jaw wire130J1 and the second jaw wire 130J2 to change the disposition path ofthe first jaw wire 130J1 and the second jaw wire 130J2 by some degree,thereby expanding the rotation radius of the first jaw 121 and thesecond jaw 122. That is, when an additional pulley is not disposed asillustrated in FIG. 9B, a first jaw 121′ and a second jaw 122′ mayrotate only up to a right angle; however, in an embodiment of thepresent invention, the additional pulleys 123J16 and 123J26 may beadditionally provided to increase the maximum rotation angle by θ asillustrated in FIG. 9A. This will be described below in more detail.

Referring to FIG. 9B, since a first jaw wire 130J1′ is fixedly coupledto a J11 pulley 123J11′ and a second jaw wire 130J2′ is fixedly coupledto a J21 pulley (not illustrated), when an additional pulley is notdisposed, the J11 pulley 123J11′ and the J21 pulley (not illustrated)may rotate only up to a line M of FIG. 9B. In other words, a coupler ofthe first jaw wire 130J1′ and the J11 pulley 123J11′ may rotate only upto the tangential direction of the first jaw wire 130J11′. In this case,when the first jaw 121′ and the second jaw 122′ performs an actuationoperation while being located at the line M of FIG. 9B, the one jaw maybe unfolded but the other jaw may not be unfolded because it may notrotate above the line M. Thus, while the first jaw 121′ and the secondjaw 122′ is performing a yaw operation by some degree or more, anactuation operation may not be smoothly performed.

In order to solve this problem, in the surgical instrument 100 accordingto an embodiment of the present invention, the J16 pulley 123J16 and theJ26 pulley 123J26 are additionally disposed as additional pulleys on oneside of the J11 pulley 123J11 and the J21 pulley 123J21. In this manner,the J16 pulley 123J16 and the J26 pulley 123J26 may be disposed tochange the disposition path of the first jaw wire 130J1 and the secondjaw wire 130J2 by some degree and thereby change the tangentialdirection of the first jaw wire 130J1 and the second jaw wire 130J2, sothat a coupler of the first jaw wire 130J1 and the J11 pulley 123J11 anda coupler of the second jaw wire 130J2 and the J21 pulley 123J21 mayrotate up to a line N of FIG. 9A. That is, the coupler of the first jawwire 130J1 and the J11 pulley 123J11 may rotate until it is located onthe internal common tangent of the J11 pulley 123J11 and the J16 pulley123J16 Likewise, the coupler of the second jaw wire 130J2 and the J21pulley 123J21 may rotate until it is located on the internal commontangent of the J21 pulley 123J21 and the J26 pulley 123J26.

In this manner, according to the present invention, the rotation radiusof the first jaw 121 and the second jaw 122 may be expanded to expandthe operation range of the normal opening/closing actuation operation.

The elements related to the rotation of the J21 pulley 123J21 will bedescribed below.

On one side of the J21 pulley 123J21, the J22 pulley 123J22 and the J24pulley 123J24 are disposed to face each other. Herein, the J22 pulley123J22 and the J24 pulley 123J24 are formed to rotate independentlyaround the Y-axis direction. Also, on one side of the J22 pulley 123J22and the J24 pulley 123J24, the J23 pulley 123J23 and the J25 pulley123J25 are disposed to face each other. Herein, the J23 pulley 123J23and the J25 pulley 123J25 are formed to rotate independently around theY-axis direction. Although it is illustrated that all of the J22 pulley123J22, the J23 pulley 123J23, the J24 pulley 123J24, and the J25 pulley123J25 are formed to rotate around the Y-axis direction, the presentinvention is not limited thereto, and the rotating axes of therespective pulleys may be formed in various directions according totheir configurations.

The second jaw operating wire 130J2 may be wound to at least partiallycontact the J23 pulley 123J23, the J22 pulley 123J22, the J21 pulley123J21, the J26 pulley 123J26, the J24 pulley 123J24, and the J25 pulley123J25, so that the second jaw operating wire 130J2 may move along theabove pulleys while rotating the above pulleys.

Thus, when the second jaw operating wire 130J2 is pulled in thedirection of an arrow J2R of FIG. 9A, the second jaw operating wire130J2 rotates the J25 pulley 123J25, the J24 pulley 123J24, the J21pulley 123J21, the J26 pulley 123J26, the J22 pulley 123J22, and the J23pulley 123J23. In this case, the J21 pulley 123J21 rotates in thedirection of an arrow R of FIG. 9A to rotate the second jaw 122together.

On the other hand, when the second jaw operating wire 130J2 is pulled inthe direction of an arrow J2L of FIG. 9A, the second jaw operating wire130J2 rotates the J23 pulley 123J23, the J22 pulley 123J22, the J21pulley 123J21, the J26 pulley 123J26, the J24 pulley 123J24, and the J25pulley 123J25. In this case, the J21 pulley 123J21 rotates in thedirection of an arrow L of FIG. 9A to rotate the second jaw 122together.

When one end portion of the first jaw operating wire 130J1 is pulled inthe direction of the arrow J1R of FIG. 9A and the other end portion ofthe first jaw operating wire 130J1 is pulled in the direction of thearrow J1L of FIG. 9A (that is, when both end portions of the first jawoperating wire 130J1 are pulled), an end tool hub 123 a and the firstjaw 121 and the second jaw 122 coupled thereto rotate around the endtool pitch operating axis 123PA in the counterclockwise direction, sothat the end tool 120 rotates downward to perform a pitch motion.

On the other hand, when one end portion of the second jaw operating wire130J2 is pulled in the direction of the arrow J2R of FIG. 9A and theother end portion of the second jaw operating wire 130J2 is pulled inthe direction of the arrow J2L of FIG. 9A, the end tool hub 123 a andthe first jaw 121 and the second jaw 122 coupled thereto rotate aroundthe end tool pitch operating axis 123PA in the clockwise direction, sothat the end tool 120 rotates upward to perform a pitch motion.

The end tool 120 of the surgical instrument 100 b according to thepresent invention further includes a pitch pulley 123P, the operator 110(see FIG. 11) further includes a pitch pulley 115P (see FIG. 11), andthe operating force transmitter 130 further includes a pitch wire 130P.In detail, the pitch pulley 123P of the end tool 120 may be fixedlycoupled with the end tool hub 123 a to rotate around the end tool pitchoperating axis 123PA along with the end tool hub 123 a. The pitch pulley115P of the operator 110 may be fixedly connected with an operator hub115 a to rotate around the pitch operating axis 1111 along with theoperator hub 115 a. Also, the pitch wire 130P may connect the pitchpulley 123P of the end tool 120 and the pitch pulley 115P of theoperator 110.

Thus, when the user grips the pitch operating handle 1112 of the pitchoperator 111 and rotates the pitch operating handle 1112 around thepitch operating axis 1111, the operator hub 115 a connected with thepitch operating handle 1112 and the pitch pulley 115P connectedtherewith rotate around the pitch operating axis 1111, the rotation ofthe pitch pulley 115P is transmitted to the pitch pulley 123P of the endtool 120 through the pitch wire 130P, and the pitch pulley 123P alsorotates together. Consequently, the end tool 120 rotates to perform apitch motion.

That is, the surgical instrument 100 according to the first embodimentof the present invention includes the pitch pulley 123P of the end tool120, the pitch pulley 115P of the operator 110, and the pitch wire 130Pof the operating force transmitter 130 to more perfectly transmit theoperating force of the pitch operation of the pitch operator 111 to theend tool 120, thereby improving the operational reliability.

(Pitch Operation Control and Wire Mirroring)

FIG. 10 is a schematic view illustrating a pitch operation of thesurgical instrument of FIG. 3, and FIG. 11 is a perspective viewillustrating a pitch operation of the surgical instrument of FIG. 3.

As described above, the operator 110 of the surgical instrument 100according to the first embodiment of the present invention furtherincludes an operator control member 115 connected with the pitchoperating axis 1111 of the pitch operator 111. The operator controlmember 115 has substantially the same configuration of the end toolcontrol member 123, and the end tool control member 123 and the operatorcontrol member 115 are disposed symmetrical to each other with respectto the YZ plane of FIG. 3. In other words, it may be said that the endtool control member 123 and the operator control member 115 are mirroredwith respect to the YZ plane of FIG. 3.

In detail, the operator control member 115 includes a J11 pulley 135J13,a J12 pulley 115J12, a J13 pulley 115J13, a J14 pulley 115J14, and a J15pulley 115J15 that are related to the rotation motion of the first jaw121, and a J21 pulley 135J23, a J22 pulley 115J22, a J23 pulley 115J23,a J24 pulley 115J24, and a J25 pulley 115J25 that are related to therotation motion of the second jaw 122.

The first jaw operating wire 130J1 may be wound to at least partiallycontact the J13 pulley 115J13, the J12 pulley 115J12, the J11 pulley135J13, the J14 pulley 115J14, and the J15 pulley 115J15 of the operatorcontrol member 115, and the first jaw operating wire 130J1 may movealong the above pulleys while rotating the above pulleys.

The second jaw operating wire 130J2 may be wound to at least partiallycontact the J23 pulley 115J23, the J22 pulley 115J22, the J21 pulley135J23, the J24 pulley 115J24, and the J25 pulley 115J25 of the operatorcontrol member 115, and the second jaw operating wire 130J2 may movealong the above pulleys while rotating the above pulleys.

Herein, the rotating axis of the J12 pulley 115J12, the J14 pulley115J14, the J22 pulley 115J22, and the J24 pulley 115J24 may beidentical to the pitch operating axis 1111 of the pitch operator 111.Also, a portion extending from the rotating axis of the J11 pulley135J13 and the J21 pulley 135J23 may be identical to the pitch operatinghandle 1112 of the pitch operator 111.

The pitch operation in the first embodiment of the present invention isperformed as follows:

When the user grips the pitch operating handle 1112 (see FIG. 2) of thepitch operator 111 of the operator 110 and rotates the pitch operatinghandle 1112 around the pitch operating axis 1111 in the direction of anarrow OP (Operator Pitch) of FIG. 10, the first jaw operating wire 130J1is pulled toward the operator 110 and moves in the direction of an arrowPJ1 of FIG. 10. At the same time, the second jaw operating wire 130J2 isunwound from the operator 110, moves toward the end tool 120, and movesin the direction of an arrow PJ2 of FIG. 10. Then, as the first jawoperating wire 130J1 is pulled toward the operator 110, the J12 pulley123J12 and the J14 pulley 123J14 rotate around the end tool pitchrotating axis 123PA in the counterclockwise direction. At the same time,as the second jaw operating wire 130J2 is pulled toward the end tool120, the J22 pulley 123J22 and the J24 pulley 123J24 rotate around theend tool pitch rotating axis 123PA in the counterclockwise direction.Consequently, the end tool hub 123 a and the first jaw 121 and thesecond jaw 122 coupled therewith rotate downward to perform a pitchmotion.

In this manner, since the end tool control member 123 and the operatorcontrol member 115 are disposed symmetrical to each other (i.e.,mirrored) with respect to the YZ plane of FIG. 3, the pitch operationmay be conveniently performed. That is, the pitch operation may beperformed regardless of the yaw operation and the actuation operation.Herein, the yaw operation refers to an operation in which the J11 pulley135J13 and the J21 pulley 135J23 of the operator control member 115rotate around the pitch operator center axis 1113 and thus the J11pulley 123J11 and the J21 pulley 123J21 of the end tool control member123 rotate around the jaw rotating axis 123JA to rotate the jaws 121 and122.

(Overall Operation of First Embodiment)

Hereinafter, an overall configuration for the pitch operation, the yawoperation, and the actuation operation of the surgical instrument 100according to the first embodiment of the present invention will besummarized with reference to the above descriptions.

For the configuration of the end tool 120 of the present embodiment, theoperating force transmitter 130 capable of dividing the operation inputof the operator 110 into a pitch operation, a yaw operation, and anactuation operation is necessary to perform the pitch, yaw, andactuation operations of the end tool 120. As described above, throughthe structure in which the end tool control member 123 and the operatorcontrol member 115 are disposed symmetrical to each other, the rotationoperation of the pitch operator 111 enables the pitch operation of theend tool 120 regardless of the operations of the yaw operator 112 andthe actuation operator 113. Also, the operating force transmissionassembly 135 is provided to convert the operation of the yaw operator112 and the actuation operator 113 into the operation of two jaws of theend tool 120, thereby connecting the operation of the yaw operator 112and the actuation operator 113 to the yaw operation and the actuationoperation of the end tool 120. That is, by the operating forcetransmission assembly 135, the rotation of the yaw operator 112 causesthe two jaws to rotate in the same direction, and the rotation of theactuation operator 113 causes the two jaws to rotate in differentdirections.

This will be described below in more detail.

First, the pitch operation will be described below.

As described above, when the user grips the pitch operating handle 1112of the pitch operator 111 of the operator 110 and rotates the pitchoperating handle 1112 around the pitch operating axis 1111 in thedirection of the arrow OP of FIG. 10, the operator control member 115also rotates around the pitch operating axis 1111. Then, the first jawoperating wire 130J1 wound around the operation control member 115 ispulled toward the operator 110 and moves in the direction of the arrowPJ1 of FIG. 10. At the same time, the second jaw operating wire 130J2wound around the operation control member 115 is unwound from theoperator control member 115 and moves in the direction of the arrow PJ2of FIG. 10. Then, the end tool control member 123 connected with thefirst jaw operating wire 130J1 and the second jaw operating wire 130J2rotates around the end tool pitch operating axis 1231 in the directionof an arrow EP of FIG. 10 to perform a pitch motion.

The yaw operation will be described below. FIGS. 12 and 13 are viewsillustrating a yaw operation of the surgical instrument of FIG. 3.

Referring to FIGS. 5, 6, 12, and 13, when the yaw operator 112 rotatesin the direction of an arrow Y of FIG. 13, the pulley 1121 a of the yawoperator 112 and the yaw pulley 135YP connected thereto through the yawwire 130Y rotate around the respective axes. Also, when the yaw pulley135YP rotates, the first gear 135G1 and the fourth gear 135G4 rotatearound the pitch operator center axis 1113 through the yaw operating bar135B.

Then, when the first gear 135G1 and the fourth gear 135G4 rotate aroundthe pitch operator center axis 1113, the first gear 135G1 rotates in thedirection of the arrow Y with respect to the second gear 135G2, thesecond jaw operating gear 135J21 formed at the second jaw operatingmember 135J2 rotates in the direction C with respect to the second jawoperating gear center axis 135J24, and the entire of the second jawoperating member 135J2 also rotates around the pitch operator centeraxis 1113 in the direction of the arrow Y.

Also, the fourth gear 135G4 rotates in the direction Y because it isintegrally connected with the first gear 135G1. In this case, the firstjaw operating gear 135J11 formed at the first jaw operating member 135J1rotates in the direction B with respect to the first jaw operating gearcenter axis 135J14, and the entire of the first jaw operating member135J1 also rotates around the pitch operator center axis 1113 in thedirection Y.

Thus, the first jaw operating member 135J1 and the second jaw operatingmember 135J2 rotate in the same direction, and the first jaw 121connected to the first jaw operating member 135J1 through the first jawwire 130J1 and the second jaw 122 connected to the second jaw operatingmember 135J2 through the second jaw wire 130J2 rotate in the samedirection to perform a yaw operation.

The actuation operation will be described below. FIGS. 14 and 15 areviews illustrating an actuation operation of the surgical instrument ofFIG. 3.

Referring to FIGS. 5, 6, 14, and 15, when the actuation operator 113rotates in the direction of an arrow A of FIG. 15, the pulley 1131 a ofthe actuation operator 113 and the actuation gear 135AG connectedthereto through the actuation wire 130A rotate around the respectiveaxes in the direction of the arrow A.

In this manner, when the actuation gear 135AG rotates around theactuation gear center axis 135AG1, the second gear 135G2 engaged withthe upper side of the actuation gear 135AG rotates in the direction J2of FIG. 15, the second jaw operating gear 135J21 engaged between thefirst gear 135G1 and the second gear 135G2 rotates in the direction Ewith respect to the second jaw operating gear center axis 135J24, andthe entire of the second jaw operating member 135J2 also rotates aroundthe pitch operator center axis 1113 in the direction of an arrow J2.

Also, when the actuation gear 135AG rotates around the actuation gearcenter axis 135AG1, the third gear 135G3 engaged with the lower side ofthe actuation gear 135AG rotates in the direction J1 of FIG. 15, thefirst jaw operating gear 135J11 engaged between the third gear 135G3 andthe fourth gear 135G4 rotates in the direction F with respect to thefirst jaw operating gear center axis 135J14, and the entire of the firstjaw operating member 135J1 also rotates around the pitch operator centeraxis 1113 in the direction of an arrow J1.

Thus, the first jaw 121 connected to the first jaw operating member135J1 through the first jaw wire 130J1 and the second jaw 122 connectedto the second jaw operating member 135J2 through the second jaw wire130J2 rotate in opposite directions to perform an actuation motion forunfolding the two jaws.

In this manner, according to the present invention, a surgicalinstrument performing an output operation of an end tool by theindependent inputs of a pitch operating member, a yaw operating member,and an actuation operating member may be implemented solely by amechanical configuration without using motors, electronic control, orsoftware. That is, since the pitch operation, the yaw operation, and theactuation operation, which affect each other, are separated from eachother solely by mechanism, the configuration of the surgical instrumentmay be significantly simplified.

Also, the rotating force of the operator 110 may be transmitted to theend tool 120 solely by the minimum gear, wire, and pulley structure. Inparticular, according to the present invention, since the operationdirection of the operator 110 is intuitively identical to the operationdirection of the end tool 120, the convenience of a surgical operatormay be improved and the accuracy of a surgical operation may beimproved. Furthermore, since the end tool control member 123 and theoperator control member 115 are disposed symmetrical to each other(i.e., mirrored) with respect to the YZ plane of FIG. 10, the pitchoperation may be conveniently performed. That is, the pitch operationmay be performed regardless of the yaw operation and the actuationoperation.

MODE OF THE INVENTION

<Second Embodiment of Surgical Instrument>

Hereinafter, a surgical instrument 200 according to a second embodimentof the present invention will be described. The surgical instrument 200according to the second embodiment of the present invention is differentin terms the configuration of an operating force transmission assembly235 from the surgical instrument 100 (see FIG. 2) according to the firstembodiment of the present invention. This difference in theconfiguration from the first embodiment will be described later indetail.

FIG. 16 is a perspective view of a surgical instrument according to asecond embodiment of the present invention, FIG. 17 is a plan view ofthe surgical instrument of FIG. 16, and FIG. 18 is a perspective viewillustrating an operator of the surgical instrument of FIG. 16.

Referring to FIGS. 16, 17, and 18, the surgical instrument 200 accordingto the second embodiment of the present invention includes an operator210, an end tool 220, an operating force transmitter 230, and aconnector 240.

The operator 210 includes a pitch operator 211 controlling a pitchmotion of the end tool 220, a yaw operator 212 controlling a yaw motionof the end tool 220, and an actuation operator 213 controlling anactuation motion of the end tool 220.

The pitch operator 211 includes a pitch operating axis 2111 and a pitchoperating handle (not illustrated). The yaw operator 212 includes a yawoperating axis 2121 and a yaw operating member 2122. The actuationoperator 213 includes an actuation operating axis 2131 and an actuationoperating member 2132.

The operating force transmitter 230 includes a yaw wire 230Y, anactuation wire 230A, a pitch wire (not illustrated), a first jaw wire230J1, a second jaw wire 230J2, and an operating force transmissionassembly 235. Herein, the operating force transmission assembly 235 maybe accommodated in the pitch operating handle 2112.

First, the operating force transmission assembly 235 of the operatingforce transmitter 230 will be described below. The operating forcetransmission assembly 235 receives the operating force of the yawoperator 212 and the actuation operator 213 and transmits the receivedoperating force to a first jaw 221 and a second jaw 222.

In detail, the operating force transmission assembly 235 includes a yawpulley 235YP, a first gear 235G1, and a fourth gear 235G4 that areconnected with the yaw operator 212 through the yaw wire 230Y to rotatealong with the yaw operator 212. Herein, the yaw pulley 235YP, the firstgear 235G1, and the fourth gear 235G4 rotate together by being connectedto each other by a yaw operating bar 235B. Also, it includes a first jawoperating member 235J1 for transmitting an operating force to rotate thefirst jaw 221 according to the rotation of the yaw operator 212 and theactuation operator 213, and a second jaw operating member 235J2 fortransmitting an operating force to rotate the second jaw 222 accordingto the rotation of the yaw operator 212 and the actuation operator 213.Also, it further includes an actuation gear 235AG rotating along withthe actuation operator 213, a second gear 235G2 interposed between thefirst gear 235G1 and the actuation gear 235AG, and a third gear 235G3interposed between the actuation gear 235AG and the fourth gear 235G4.In this case, the first gear 235G1, the second gear 235G2, the thirdgear 235G3, and the fourth gear 235G4 may be sequentially stacked andformed in the direction of a pitch operator center axis 2113 to rotatearound the pitch operator center axis 2113. Herein, the actuation gear235AG rotates around an actuation gear center axis 235AG1 that isfixedly formed in the direction perpendicular to the Z axis. Theactuation gear 235AG is connected with the actuation wire 230A to rotatealong with the pulley 2131 a of the actuation operator 213. This will bedescribed below in more detail.

The first jaw operating member 235J1 includes a first jaw operating gear235J11, a first jaw connecting member 235J12, a first jaw operatingpulley 235J13, and a first jaw operating gear center axis 235J14. Thefirst jaw operating gear 235J11 is interposed in the form of a bevelgear between the first gear 235G1 and the second gear 235G2 to revolvearound the pitch operator center axis 2113 or rotate around the firstjaw operating gear center axis 235J14 according to the relative movementof the first gear 235G1 or the second gear 235G2. The first jawconnecting member 235J12 may be formed to connect the first jawoperating gear center axis 235J14 and the first jaw operating pulley235J13, so that the first jaw operating gear 235J11, the first jawoperating gear center axis 235J14, the first jaw connecting member235J12, and the first jaw operating pulley 235J13 may rotate togetheraround the pitch operator center axis 2113. The first jaw operatingpulley 235J13 may be connected with the first jaw wire 230J1 to transmitthe rotation of the yaw operator 212 and the actuation operator 213 tothe first jaw 221.

Herein, the first jaw connecting member 235J12 may be formed to connectto the pitch operator center axis 2113 and may be formed in the shape ofbars extending respectively in different directions from the pitchoperator center axis 2113, one of the bars may be formed to connect withthe first jaw operating gear 235J11, and the other bar may be formed toconnect with the first jaw operating pulley 235J13. In this case, thebar connected with the first jaw operating pulley 235J13 may be formedto be more distant from the pitch operator center axis 2113 than thesecond jaw connecting member 235J22. Thus, the first jaw connectingmember 235J12 and the second jaw connecting member 235J22 may notcollide with each other. That is, since the bar connected with the firstjaw operating pulley 235J13 is formed to be distant from the pitchoperator center axis 2113, the first jaw operating member 235J1 and thesecond jaw operating member 235J2 may rotate freely without interferingwith each other.

The second jaw operating member 235J2 includes a second jaw operatinggear 235J21, a second jaw connecting member 235J22, a second jawoperating pulley 235J23, and a second jaw operating gear center axis235J24. The second jaw operating gear 235J21 is interposed in the formof a bevel gear between the first gear 235G1 and the second gear 235G2to revolve around the pitch operator center axis 2113 or rotate aroundthe second jaw operating gear center axis 235J24 according to therelative movement of the third gear 235G3 or the fourth gear 235G4. Thesecond jaw connecting member 235J22 may be formed to connect the secondjaw operating gear center axis 235J24 and the second jaw operatingpulley 235J23, so that the second jaw operating gear 235J21, the secondjaw operating gear center axis 235J24, the second jaw connecting member235J22, and the second jaw operating pulley 235J23 may rotate togetheraround the pitch operator center axis 2113. The second jaw operatingpulley 235J23 may be connected with the second jaw wire 230J2 totransmit the rotation of the yaw operator 212 and the actuation operator213 to the second jaw 222.

Although the present invention has been described with reference to theembodiments illustrated in the drawings, this is merely an example andthose of ordinary skill in the art will understand that variousmodifications may be made therein. Thus, the spirit and scope of thepresent invention should be defined by the appended claims.

INDUSTRIAL APPLICABILITY

The present invention may be applied to surgical instruments that may bemanually operated to perform laparoscopic operations or various surgicaloperations.

The invention claimed is:
 1. An end tool comprising: a first jaw and asecond jaw configured to rotate independently of each other; a J11pulley coupled with the first jaw and configured to rotate around afirst axis formed at an end tool hub; a J16 pulley formed at one side ofthe J11 pulley and configured to rotate around a second axis formed atone side of the first axis; a J12 pulley and a J14 pulley formed at oneside of the J16 pulley, and configured to rotate around a third axisformed at a predetermined angle with the first axis, and formed at oneside of the end tool hub; a J21 pulley coupled with the second jaw andconfigured to rotate around an axis that is substantially identical toor parallel to the first axis; a J26 pulley formed at one side of theJ21 pulley and configured to rotate around an axis that is substantiallyidentical to or parallel to the second axis; and a J22 pulley and a J24pulley formed at one side of the J26 pulley and configured to rotatearound an axis that is substantially identical to or parallel to thethird axis, wherein the end tool further comprises: a first jaw wireconfigured to at least partially contact the J12 pulley, the J11 pulley,the J16 pulley, and the J14 pulley; and a second jaw wire configured toat least partially contact the J22 pulley, the J21 pulley, the J26pulley, and the J24 pulley, wherein a pair of strands of the first jawwire wound around the J11 pulley are disposed, by the J16 pulley, at oneside with respect to a plane perpendicular to the third axis and passingthe first axis, wherein a pair of strands of the second jaw wire woundaround the J21 pulley are disposed, by the J26 pulley, at the oppositeside with respect to the plane perpendicular to the third axis andpassing the first axis.
 2. The end tool of claim 1, wherein the J16pulley is disposed on the opposite side of the first jaw and the secondjaw with respect to the J11 pulley; and the J26 pulley is disposed onthe opposite side of the first jaw and the second jaw with respect tothe J21 pulley.
 3. The end tool of claim 1, wherein the first axis andthe third axis are configured to be substantially perpendicular to eachother.
 4. The end tool of claim 1, wherein the first jaw wire is fixedlycoupled to the J11 pulley; and the second jaw wire is fixedly coupled tothe J21 pulley.
 5. The end tool of claim 1, wherein the J16 pulley isconfigured to have a smaller diameter than the J11 pulley; and the J26pulley is configured to have a smaller diameter than the J21 pulley. 6.The end tool of claim 1, wherein a connector hub is configured to rotatearound the third axis with respect to the end tool hub at one side ofthe end tool hub; and the J12 pulley, the J14 pulley, the J22 pulley,and the J24 pulley are formed on a common axis of the end tool hub andthe connector hub.
 7. The end tool of claim 6, wherein at the connectorhub, a J13 pulley and a J15 pulley are configured to rotate around anaxis that is substantially parallel to the third axis; and a J23 pulleyand a J25 pulley are configured to rotate around an axis that issubstantially parallel to the third axis.
 8. The end tool of claim 7,wherein the first jaw wire is configured to pass between the J12 pulleyand the J13 pulley; and the second jaw wire is configured to passbetween the J22 pulley and the J23 pulley.
 9. The end tool of claim 1,wherein a yaw motion and an actuation motion of the end tool areperformed by the first jaw wire rotating the J11 pulley connected to thefirst jaw and the second jaw wire rotating the J21 pulley connected tothe second jaw; and a pitch motion of the end tool is performed bypulling both sides of the first jaw wire wound around the J11 pulley orpulling both sides of the second jaw wire wound around the J21 pulley.10. The end tool of claim 1, wherein with respect to the first jaw wireor the second jaw wire, a pitch motion of the end tool is performed bypulling both sides of the wire wound around the end tool.
 11. The endtool of claim 1, wherein with respect to the first jaw wire or thesecond jaw wire, a yaw motion or an actuation motion of the end tool isperformed by pulling one side of the wire wound around the end tool andpushing the other side thereof.
 12. The end tool of claim 1, wherein thepair of strands of the first jaw wire wound around the J11 pulley aredisposed at the same side with respect to the second axis; and the pairof strands of the second jaw wire wound around the J21 pulley aredisposed at the same side with respect to the second axis.
 13. The endtool of claim 1, wherein any one side of the first jaw wire wound aroundthe J11 pulley is configured to pass between the J11 pulley and the J16pulley; and any one side of the second jaw wire wound around the J21pulley is configured to pass between the J21 pulley and the J26 pulley.14. A surgical instrument comprising the end tool of claim
 1. 15. Theend tool of claim 1, wherein the first jaw wire is located on aninternal tangent of the J11 pulley and the J16 pulley, and a rotationangle of the J11 pulley is expanded by the J16 pulley, the second jawwire is located on an internal tangent of the J21 pulley and the J26pulley, and a rotation angle of the J21 pulley is expanded by the J26pulley.
 16. The end tool of claim 1, wherein the J12 pulley and the J14pulley is located at one side with respect to the plane perpendicular tothe third axis and passing the first axis, the J22 pulley and the J24pulley is located at the opposite side with respect to the planeperpendicular to the third axis and passing the first axis.
 17. The endtool of claim 1, wherein the first jaw wire and the J11 pulley arefixedly coupled to each other by a coupler, the first jaw wire islocated on an internal tangent of the J11 pulley and the J16 pulley,such that a rotation angle of the coupler is expanded.
 18. The end toolof claim 17, wherein the coupler of the first jaw wire and the J11pulley is rotatable until the coupler is located on the internal tangentof the J11 pulley and the J16 pulley.
 19. An end tool comprising: afirst jaw and a second jaw configured to rotate independently of eachother; a J11 pulley coupled with the first jaw and configured to rotatearound a first axis formed at an end tool hub; a J16 pulley formed atone side of the J11 pulley and configured to rotate around a second axisformed at one side of the first axis; a J12 pulley and a J14 pulleyformed at one side of the J16 pulley, and configured to rotate around athird axis formed at a predetermined angle with the first axis, andformed at one side of the end tool hub; a J21 pulley coupled with thesecond jaw and configured to rotate around an axis that is substantiallyidentical to or parallel to the first axis; a J26 pulley formed at oneside of the J21 pulley and configured to rotate around an axis that issubstantially identical to or parallel to the second axis; and a J22pulley and a J24 pulley formed at one side of the J26 pulley andconfigured to rotate around an axis that is substantially identical toor parallel to the third axis, wherein the end tool further comprises: afirst jaw wire configured to at least partially contact the J12 pulley,the J11 pulley, the J16 pulley, and the J14 pulley; and a second jawwire configured to at least partially contact the J22 pulley, the J21pulley, the J26 pulley, and the J24 pulley, wherein the first axis andthe second axis are configured to be substantially parallel to eachother.
 20. An end tool comprising: a first jaw and a second jawconfigured to rotate independently of each other; a J11 pulley coupledwith the first jaw and configured to rotate around a first axis formedat an end tool hub; a J16 pulley formed at one side of the J11 pulleyand configured to rotate around a second axis formed at one side of thefirst axis; a J12 pulley and a J14 pulley formed at one side of the J16pulley, and configured to rotate around a third axis formed at apredetermined angle with the first axis, and formed at one side of theend tool hub; a J21 pulley coupled with the second jaw and configured torotate around an axis that is substantially identical to or parallel tothe first axis; a J26 pulley formed at one side of the J21 pulley andconfigured to rotate around an axis that is substantially identical toor parallel to the second axis; and a J22 pulley and a J24 pulley formedat one side of the J26 pulley and configured to rotate around an axisthat is substantially identical to or parallel to the third axis,wherein the end tool further comprises: a first jaw wire configured toat least partially contact the J12 pulley, the J11 pulley, the J16pulley, and the J14 pulley; a second jaw wire configured to at leastpartially contact the J22 pulley, the J21 pulley, the J26 pulley, andthe J24 pulley; and a pitch pulley coupled to the end tool hub andconfigured to rotate around the third axis.